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Causes and Treatment of Atopic Dermatitis

14 September 2010. Causes and Treatment of Atopic Dermatitis. Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University. Contents. Characteristic of Atopic Dermatitis (AD) Causes of AD Treatment of AD Prevention of AD. Definition Symptom.

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Causes and Treatment of Atopic Dermatitis

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  1. 14 September 2010 Causes and Treatment of Atopic Dermatitis Dong Seok Cha, Ph.D. Department of Oriental Pharmacy College of Pharmacy Woosuk University

  2. Contents • Characteristic of Atopic Dermatitis (AD) • Causes of AD • Treatment of AD • Prevention of AD • Definition • Symptom • Genetic factor • Environmental factor • Immune system imbalance • Dysfunction of skin barrier • Avoiding allergens • Drug treatment • Phototherapy • Alternative Treatment

  3. Characteristic of Atopic Dermatitis

  4. What is Atopic Dermatitis? • Atopy or atopic syndrome • = allergic hypersensitivity • Dermatitis • = inflammation of the skin • Atopic Dermatitis (AD) • A type of eczema • Non-contagious • Often begins in childhood and may persist into adulthood. • Occurs together with other atopic diseases

  5. Prevalence Rate of Atopic Dermatitis

  6. Symptoms of Atopic Dermatitis Atopic Dermatitis

  7. Causes of Atopic Dermatitis

  8. Causes of Atopic Dermatitis Genetic factor Environmental factor Immune system imbalance Dysfunction of skin barrier

  9. Causes of AD – Genetic Factor • Family history is very important • The inheritance pattern is complex • AD genetics involve several genes, each with a different function • - IgE response related gene • - skin barrier function related gene • - skin inflammation related gene • Genetic mutation of the epidermal barrier protein, filaggrin is one predisposing factor for atopic dermatitis

  10. Causes of AD – Genetic Factor

  11. Causes of AD – Environmental Factor • Industrialization • Hygiene hypothesis • Dietary life • Food allergy • Trans fat • Residential Environment • Aeroallergens • eg. dust mites, pollens, animal danders • VOCs • eg. formaldehyde, benzene Sick building syndrome

  12. Causes of AD - Immune System Imbalance Th2 Th1 [Homeostatic state] Th2 Th1 Th1 Th2 [Cell-mediated Immunity] [Allergy / Atopy]

  13. Causes of AD - Immune System Imbalance

  14. Causes of AD – Dysfunction of Skin Barrier TEWL Allergen Irritant Chronic Stage of AD Skin Barrier Function Ceramide

  15. Treatment of Atopic Dermatitis

  16. Treatment of Atopic Dermatitis • Treatment for Atopic Dermatitis has multidimensional aims • Improving the skin barrier function • Reducing the inflammation • Identifying the responsible triggers • Preventing any secondary infection • Common treatment options for AD • - Avoiding allergens • Drug treatment • Phototherapy • Alternative therapy

  17. Treatment of AD – Avoiding Allergens • Discovering the triggers of allergic reactions • Learning to avoid them.

  18. Treatment of AD – Drug Treatment • Topical Treatment • - Emollient (moisturizer) • - Topical corticosteroids • - Topical calcineurin inhibitors • eg. Pimecrolimus and Tacrolimus • - Topical antimicrobial therapy • - Coal tar • Systemic Treatment • - Antihistamines • - Corticoteroids • - Immunomodulators • eg. Azathioprine • - Antimicrobials

  19. Treatment of AD – Recent Drugs Being Tested for AD • Corticosteroids, immunosuppressants have serious side effects • AD imposes tremendous social and financial costs on patients Improved drugs are necessary Leukotriene antagonist Monoclonal antibodies Leflunomide Recombinant interferon-gamma

  20. Treatment of AD – Phototherapy • Ultraviolet (UV) light therapy • Works as an anti-inflammatory agent • Various type of UV • - Psoralen plus UVA (PUVA) • - A combination of broadband UVB/UVA light treatment • - Broadband UVA exposure • - Broad-band UVB exposure • - Narrowband UVB (280-320 nm) • - UVA-1 (340-400 nm) • Side effects • - stinging, burning, ageing of the skin, pigmentation • - risk of squamous cell carcinoma and melanoma.

  21. Treatment of AD – Alternative Therapy • Currently, the level of interest in alternative treatments continues to increase • Traditional herbal medicine formulation • External application • Combined internal and external treatment

  22. Prevention of Atopic Dermatitis

  23. Prevention of Atopic Dermatitis Diet Mental health care Skin care Lifestyle

  24. Thank you for your attention

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